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Diagnostic Dogma

A tag exploring how medical diagnoses can become entrenched frameworks, sometimes treated as settled conclusions rather than continually testable hypotheses. Posts examine the role of clinical authority, diagnostic criteria, evidentiary standards, and alt

64 posts
Nine Specialists Challenge the Conflation of POTS, Dysautonomia and FND
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Nine medical specialists warn that POTS and other autonomic disorders are being confused with FND, exposing patients to misdiagnosis, diagnostic overshadowing and potentially inappropriate rehabilitation. Their 2024 paper examines the diagnostic evidence, comorbidity claims and consequences of treating physiological disorders as functional.

The Boeing 747 School of Neurology: Shut Up, I'm the Pilot
15 hours ago Author profile image Quackademic
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Apparently, FND has neurological characteristics found nowhere else in medicine. Which ones? Excellent question. Unfortunately, instead of an answer, we've been offered a lecture about pilots, professional qualifications and AIDS denialism. Welcome aboard. Scientific evidence is apparently not included in the ticket price.

18 Months of Neurological Decline, a Psychosomatic Label, and the Lyme Infection They Missed

A 54-year-old woman spent more than 18 months experiencing progressive neurological symptoms before doctors identified late Lyme neuroborreliosis and spinal cord inflammation. Her symptoms had been attributed to psychosomatic causes, despite worsening mobility, bladder and bowel dysfunction, and significant weight loss. A 2025 case report documents the diagnostic delay, the evidence that overturned the earlier assumption, and the lasting disability after treatment.

The MRI Was Normal. The Lesion Was Still There.

Studies using 7 Tesla MRI have uncovered neurological lesions missed by conventional scans, sometimes confirmed through surgery and pathology. So how much confidence should clinicians place in a normal MRI, and what happens when they decide patients do not need imaging at all?

“FND Fundamentalists”: New Study Exposes Deep Divisions Over Functional Neurological Diagnoses

An international study involving 1,853 patients and 400 clinicians reveals profound disagreements over FND diagnoses in autoimmune disease, reports of diagnostic overshadowing, and clinical reasoning that raises important questions about whether neurological symptoms attributed to FND may have different underlying causes.

When Everything Looks Functional: Ten Claims, One Convenient Diagnosis
1 week ago Author profile image Quackademic
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ME/CFS? Stop pacing. Long COVID? Think functional. POTS, MCAS or CCI? Perhaps FND. We examine ten controversial public statements from an FND-specialist physical therapist, the evidence behind them, and the potential consequences for patients.

Before You Criticise FND, Apparently You Must First Prove You're Not a Terrible Person

Polly Patterson questioned FND diagnoses in post-viral illness, carefully explaining that she wasn't dismissing patients or denying their suffering. FND Action's Kim Hearne responded with a nine-part critique. The exchange reveals how easily legitimate questions about medical practice become arguments about compassion, credibility and stigma.

When Lyme Disease Symptoms Persist: What Do We Actually Know?

Lyme disease can have lasting consequences, but persistent symptoms do not necessarily mean persistent infection. We examine untreated infection, reinfection, treatment limitations, PTLDS and the difficult questions raised when patients with unresolved neurological symptoms receive an FND diagnosis. Drawing on published research, patient accounts and discussions on FND Nope, we also explore how clinical terminology can obscure rather than clarify diagnostic uncertainty.

When Drug-Induced Neurological Damage Gets Labelled FND

Psychiatrist David Healy challenges the use of FND diagnoses in patients experiencing persistent medication-related neurological symptoms, warning that drug toxicity can be overlooked, patients dismissed and potentially harmful treatments repeated.

FND Study of Nearly 600,000 Patients Reveals Different Biological Patterns Behind Different Symptoms

A major 2026 study links FND diagnoses to inherited disorders, congenital abnormalities, neurodevelopmental conditions and early-life biological factors. But are these vulnerabilities to FND, or evidence that different biological diseases produce overlapping clinical phenotypes? We examine the findings through the Common Phenotypes Hypothesis.